Thursday, June 25, 2015

Senate Majority Leader Mitch McConnell isn’t alone
in rethinking the role of Confederate icons in 21st Century America.

The Kentucky Republican said Tuesday that a statue
of Kentucky-born Jefferson Davis, the first and only president of the Confederacy,
may be out of place in his home state’s Capitol Rotunda.

A better spot could be the Kentucky history museum,
McConnell told reporters. Some state politicians agree, but it’s hardly a done
deal.

New Orleans Mayor Mitch Landrieu says it’s time for his
city to remove a prominent statue of Robert E. Lee, and a pastor there wants
one of Davis removed. Students at the University of Texas at Austin have
demanded the removal of a Davis statue on campus to a museum,“so it could be
learned from instead of revered.”

The carnage in Charleston brought a backlash against
the Confederate battle flag that now invites us to rethink not just symbols but
how we present our past.

Cities, counties and states are struggling with what
we should do about streets and statues that honor Confederate heroes. A few, like Monument Avenue in Richmond, Va., are designated
a National Historic Landmark and listed on the National Register of Historic Places
as architecturally significant to the entire nation.

It’s one thing to see Confederates honored at home
but quite another to find their monuments in a place of national honor in the U.S.
Capitol. And yet several of the 100 statues that states have donated to the
National Statuary Hall Collection over the years memorialize Confederate
soldiers and sympathizers. Not one represents an African American.

National Statuary Hall has its roots in the Civil
War. When the House outgrew its old Chamber, a representative from Vermont proposed
in 1864 that each state select citizens worthy of “lasting commemoration” and send
their statuary likenesses to the Capitol.

Each of the 50 states choose two figures “illustrious
for their historic renown” and honor them in marble or bronze. Confederate
heroes on display include: Davis of
Mississippi, Confederate Vice President Alexander Stephens of Georgia,
commanding Gen. Robert E. Lee of Virginia, rebel hero and Reconstruction foe
Wade Hampton of South Carolina, and governor and military leader Zebulon Baird
Vance of North Carolina.

Virginia donated statues of favorite sons George
Washington and Lee, over Union veterans’ objections to Lee.

By 1933, Statuary Hall was overcrowded. Statues stood
three deep in some places, and there were concerns the floor would not support
more weight. So, the statues are spread throughout the Capitol complex. Washington’s
statue is in the Rotunda, Lee’s in the Crypt.

Congress commissioned a statue of Rosa Parks, the
first full-length statue of a black person in the Capitol, and it was dedicated
in Statuary Hall in 2013. Congress-commissioned busts
of Martin Luther King Jr. and Sojourner Truth also are in the Capitol. A statue
of Frederick Douglass, donated by the District of Columbia, is in the Capitol
Visitor Center.

Since 2000, Congress has allowed states to remove
and replace statues, and a handful of states have retired old soldiers. Some
have installed modern icons – Dwight Eisenhower, Gerald Ford, Ronald
Reagan.

In 2009, Alabama removed the statue of J.L.M. Curry
and replaced it with one of Helen Keller. Curry was a secessionist and Confederate
officer who later became an education reformer. The
Curry School of Education at the University of Virginia is named for Curry, who
is buried at Hollywood Cemetery in Richmond.

Alabama’s other statue
is of Confederate Gen. Joseph Wheeler. He at least later served the United
States in the war with Spain.

Ohio is replacing former Gov. William Allen, who
backed slavery and criticized Lincoln, with Thomas Edison.

Rep. Kathy Castor, D-Fla., wants her state to remove
the statue of Confederate Gen. Edmund Kirby Smith from the Capitol and replace
it with someone who has made more lasting, positive contributions. Florida’s
other statue is of Dr. John Gorrie, the father of air conditioning.

So far, Mississippi’s senators are defending Davis’s
place in the U.S. Capitol. Mississippi’s second statue is of Confederate Col.
and white supremacist James Zachariah George.

With all that’s happened in the last 150 years, it’s
time we updated our heroes. It’s time for states to bring their Confederates home
and put the statues in museums where they belong. The war should end at last.

In just 15 years, 67 million people — one in five Americans — will be 65 and older. The forum, co-sponsored by the Schaeffer Center and the Brookings Institution, a Washington-based think tank, kicked off a joint effort aimed at helping policymakers plan and modernize Medicare to meet impending challenges.

The half-day session brought together a distinguished list of economists and former administrators of the Centers for Medicare and Medicaid Services and its predecessor, the Health Care Financing Administration (HCFA), to focus on some of Medicare’s thorniest issues, including the wealth and poverty of beneficiaries, choice and competition among plans, program design and provider payment reform.

“I’ve been concerned for quite some time that health care costs are driving our accumulated deficit and have the potential to negatively impact our economy and our national security,” said Leonard D. Schaeffer, who in 2009 established the USC center that bears his name.

Medicare management

Schaeffer, who holds the Judge Robert Maclay Widney Chair at USC, was an administrator of HCFA and was responsible for the federal Medicare and Medicaid programs from 1978 to 1980.

Schaeffer noted that when he joined the agency, “we were concerned already about how to ensure that Medicare was both well-managed and that we were able to control costs.”

There also was a dawning realization in the late 1970s of the ability to collect and integrate health data, he said.

“What we didn’t anticipate was resistance to turning that data into information that could be used to improve medical practice and inform health care policy,” said Schaeffer, a member of the boards of trustees at both USC and Brookings.

Forum speakers included USC Price School of Public Policy Professor Paul Ginsburg, holder of the Norman Topping Chair in Medicine and Public Policy, and Gail Wilensky, senior fellow at Project HOPE and a former HCFA administrator.

Trending in the wrong direction

By almost every measure, Medicare has been a great success, but 50 years after President Lyndon B. Johnson signed Medicare into law, some health trends are heading in the wrong direction.

In 2030, a man and woman age 65 can expect to spend 7.4 and 9.8 years, respectively, with a disability, Goldman explained. Disability is defined as having one or more limitation in activities of daily living, such as being unable to take medications, bathe or dress.

Not only will more people be disabled for a longer time, they’ll also face slightly fewer healthy months of life than 65-year-olds did in 2010. A larger number of Medicare beneficiaries in 2030 will have more chronic conditions — such as hypertension, diabetes and heart disease — than beneficiaries in 2010, Goldman said.

Warning flags

Researchers at USC used the Future Elderly Model (FEM), a simulation model that Goldman and his colleagues developed, to create the snapshot of changing demographics and spending for Medicare from 2010 and 2030. Researchers also use the FEM to analyze the declining progressivity of Medicare, that is, the degree to which higher-income people get more benefit from Medicare than do lower-income people.

Such projections “are raising warning flags,” Goldman said. “The goal for public policy and for our health care spending isn’t just to increase life expectancy” but to increase years of healthy life for all.

Medicare traditionally has focused on battling diseases such as cancer and heart disease. The FEM is helping predict how medical breakthroughs to delay aging might affect Medicare spending.

Medicare will have 27 million more beneficiaries in 2030 than in 2010 and will spend much more per the lifetime of a beneficiary — $223,000 in 2030 compared with $131,000 in 2010, Goldman said.

A rising price tag

The Medicare price tag in 2030 is projected to be $1.2 trillion annually (in constant 2009 dollars), more than twice what it was in 2010. Advances in medical technology and pharmaceuticals could either exacerbate or alleviate trend to ever-higher costs, he said.

One area of agreement in the politically fraught world of Medicare policy is the need for payment reform. There’s widespread enthusiasm for reforming the way Medicare providers are paid because it could help reduce costs and improve care, said USC’s Ginsburg, who is also a non-resident fellow at Brookings and who presented a paper on payment reform with Wilensky.

“Whether [reform] will succeed depends on how it’s implemented,” he said. “Payment models need to be improved and elements of compulsion need to be employed, such as selective mandates and incentives, so that more suitable benchmarks can be used.

Thursday, June 18, 2015

When the founding fathers talked about freedom, they never envisioned
artery-clogging trans fats or the microwave popcorn, frozen pizzas and other
processed foods that contain them.

But when the federal government started slow-walking toward a ban of artificial
trans fats, critics invoked the freedom to eat whatever they please, regardless
of the cost to their health, as if it were guaranteed by the Constitution.

The conservative Heritage Foundation warned about “Government Control of
Your Diet: Threats to `Freedom to Eat,’” in a 2013 issue brief about the evils
of nutrition information on menus and of food bans.

“There are some lines the government should never cross. This certainly
includes seeking to control what people eat,” wrote Daren Bakst, research
fellow in agricultural policy at Heritage.

Even if you agree, it’s hard to argue with the many medical studies
since 1993 that have linked partially hydrogenated oils and heart disease. Trans
fats raise LDL or “bad” cholesterol and lower the HDL or “good” cholesterol,
increasing the risk of heart disease, the leading cause of death in the United
States.

The federal government estimates that eliminating trans fats could
prevent 20,000 heart attacks and 7,000 heart-disease deaths a year in the
United States.

Other countries -- Denmark, Austria, Hungary, Norway, Iceland and
Switzerland – already have set limits on trans fats. In California, a 2008 law limits
trans fats in restaurants. The cities of New York, Boston and Philadelphia have
similar measures.

But our federal government moves with glacial speed. On Tuesday, the Food
and Drug Administration finally ordered food manufacturers to stop using trans
fats -- unless they get approval for the additive – by June 18, 2018.

Critics say the new rule is ridiculous and unnecessary. Since 2006, food
manufacturers have been required to list trans fats on Nutrition Facts labels,
and they voluntarily cut the amount. Heeding consumer demand, many large
companies -- including Wal-Mart, Starbucks and McDonalds – have cut trans fats.

Trans fat consumption dropped nearly 80 percent between 2003 and 2012,
but current intake is still a health concern as there’s no safe level of trans
fats, FDA said.

Public health groups were joyful about FDA’s announcement, and manufacturers
were relieved to have three more years to reformulate their products. The cost
to manufacturers is estimated at $6.2 billion but the benefit in reduced
medical costs is $140 billion over 20 years, FDA estimated.

The idea of adding hydrogen to oil to make a solid fat was a 20th
century invention that brought us Crisco as an alternative to lard. Trans fat
won the hearts of food manufacturers, bakeries and restaurants because it
inexpensively extends shelf life, improves texture and enhances taste.

At first it was thought that trans fat would also be healthier than
natural saturated fats, but over time medical studies showed otherwise.

To avoid trans fats, check a product’s ingredient list for partially
hydrogenated oils. Even if the Nutrition Facts label lists “0 grams” of trans
fats, the product can have half a gram per serving, and that can add up.
Besides pizza and microwave popcorn, trans fats are found in frostings,
packaged pies, stick margarines and coffee creamers.

Conservatives view FDA’s rule as more overreach by the Obama
administration, a shove down the slippery slope to give government more power
over what we eat.

Critics argue that everything from nutrition labels and calorie counts
at restaurants to capping the size of sugary drinks infringes on personal
freedom, as former New York Mayor Michael Bloomberg learned when he tried to
limit drink size. Ultimately, the state’s highest court said no.

Last November, voters in Berkeley, Calif.,
overwhelmingly passed a 1-cent per ounce tax on sugary drinks to be added to
drink distributors’ business license fees.

In Texas, though, the new agriculture commissioner, Sid Miller, favors
allowing school districts to bring back deep fat fryers and soft drinks. The
state banned both in public schools a decade ago.

“It’s not about french fries; it’s about freedom,” Miller says.

Really? Even Crisco has modernized and greatly reduced its trans fat
content. For most of us, freedom means good health.

Newspapers that shunned the A word reported on automotive
mishaps, incidents and collisions. Blow-dried TV announcers and traffic
reporters shouting over helicopter noise favored the more vivid noun crash.

Copy editors weren’t the only sticklers for the
right word to describe highway misfortune. Years ago, the National Highway
Traffic Safety Administration tried to expunge the concept of traffic accidents.

By eliminating the word in speeches, news releases
and publications, it hoped in 1997 to re-educate people that car wrecks weren’t
acts of God but predictable and preventable events.

The agency also launched a “Crashes are not accidents”
campaign. From time to time, other groups have taken up the cause, but people hang
onto the idea of tragic highway accidents. Now, though, while we can’t stop the
lethal combination of speed and distance, we at least buckle our seat belts.

Technology is making
cars safer. Backup cameras help you park and avoid pedestrians. Lasers or radar
in adaptive cruise control keep your car a safe distance from the one ahead and
warn if you veer out of your lane.

But what happens when technology – and not a human
-- controls the car?

This summer, Google will test the prototype of its
fully self-driving car on city streets in Mountain View, Calif. The cautious
two-seater won’t exceed the grand speed of 25 mph. Other companies working on
driverless cars include General Motors, Tesla, Mercedes-Benz and the Chinese
Web company Baidu.

States are eager to get on board. Michigan, Florida,
Nevada and Washington, D.C., have passed laws allowing automakers to test driverless
cars. Virginia Gov. Terry McAuliffe in March proclaimed the commonwealth “open for business” for the testing and
deployment of autonomous vehicles.

In Northern Virginia, 70
miles of busy highways – parts of Interstates 66, 95 and 495 and U.S. Routes
29 and 50 -- could be used to test self-driving cars within a year, the Richmond
Times-Dispatch reported June 1.

The potential for safer highway travel has instant
appeal. Autonomous vehicles don’t drive drunk or send texts or take selfies
behind the wheel. But they do have to deal with humans in other cars.

Since Google began testing self-driving cars in 2009,
the vehicles have logged nearly 2 million miles with a dozen minor accidents –
but “Not once was the self-driving car the cause of the accident,” the company
announced. Other motorists rear-ended or sideswiped the autonomous car, or the
car was in manual mode and its human driver at fault.

The cars don’t have to be perfect; they just have to
beat humans at driving, developers say. But that seems a low bar. Humans are
terrible drivers.

In 2010, there were
33,000 traffic deaths, nearly 4 million injuries and 24 million vehicles
damaged in motor vehicle crashes in the United States, the highway traffic
safety administration reported last month. It still avoids the word accident.

Meanwhile, states are struggling with new rules of
the road. California allows self-driving cars on public roads but requires a
steering wheel, brake pedal and accelerator – and a trained safety driver who
can take over in case there’s a problem.

That may lead to a false sense of security. Google in
the fall of 2012 started letting its employees take home self-driving Lexus
SUVs. The employees promised to be ever-alert and take the wheel as necessary.
It didn’t work out.

“We discovered something we really hadn’t seen
coming but was obvious in retrospect,” Astro Teller, the improbably named
director of Google’s Project X, the division that explores innovative products,
said last month in a South by Southwest
talk.

“Once people trust the system, they trust it. Our
success was itself a failure,” he said. “The assumption that people can be a
reliable backup for the system was a total fallacy.”

The only way a driverless car will work, Google
decided, is to make it totally driverless. No steering wheel, no brake pedal,
no accelerator. The car must drive itself from Point A to Point B at the push
of a button.

“That has been a lot more work than we thought, but
it’s the right thing to do,” Teller said.

Google’s decision to adjust the technology to fit the
human – rather than expecting the human to adjust to the technology -- is a
good lesson for us all. Experiment, yes, and take the time for safety. Crashes
are not accidents.

Tuesday, June 2, 2015

Not many people catch a wave of public emotion the
way Surfer Dude did when he died at 23.

He hadn’t been seen since February and many on the Virginia
coast feared the worst. Volunteer firefighters known as saltwater cowboys kept
searching until they found his remains last month at the remote, southern end
of Assateague Island off the Eastern Shore.

On Facebook, news of Surfer Dude’s death received more
than 51,000 page views and hundreds of condolences in two days. The New York
Times, USA Today, many other newspapers and TV networks ran stories about his
demise.

“He was the man,” Denise Bowden, a spokeswoman for
the Chincoteague Volunteer Fire Company, told the Associated Press.

What’s surprising about all the attention is that he
may have been “the man” but Surfer Dude wasn’t a man.

He was a Chincoteague wild pony. Not just any pony, but a stallion legendary
for siring dozens of offspring.

Decades after Marguerite Henry’s 1947 children’s
book, “Misty of Chincoteague,” and the 1961 movie version put the windswept fishing
village on the tourist map, the island’s wild ponies still enchant young and
old and draw huge crowds to the island. The sadness people shared about Surfer
Dude’s death speaks to the need we humans have for a connection to nature.

About 1.5 million people annually visit Chincoteague
National Wildlife Refuge, where the wild ponies roam, making it the sixth most
visited refuge in the country. Forty
thousand visitors are expected for the 90th annual pony swim and
auction July 29 and 30, where some of Surfer Dude’s foals will be sold.

It’s the season when people turn to nature as the
antidote to stale air, information overload and our unhealthy attachment to
electronic devices. For me, spending a weekend outdoors at the refuge and
Assateague Island National Seashore adjoining the refuge was restorative beyond
measure.

Time outdoors in the
presence of God’s grandeur clears the head and helps us see ourselves as part
of a larger picture. No wonder some doctors now prescribe a walk in the park
instead of pills.

You don’t have to go to Chincoteague to get the
benefit. Every state has at least one national wildlife refuge. Find one near
you by entering your Zip code on the U.S. Fish and Wildlife Service’s site,
http://www.fws.gov/refuges/

About 47 million people last year visited a wildlife
refuge, where recreation centers on the “Big Six” activities – wildlife
observation, environmental education and interpretation, hunting, fishing and photography.

Few people think of thanking Washington for the
pleasure of walking, relaxing or fishing on a pristine beach, swimming and
surfing, biking and hiking on nature trails or marveling at waterfowl and other
birds and animals – but they should.

Since President Theodore Roosevelt signed an
executive order in 1903 permanently setting aside Pelican Island in Florida as
the first national wildlife refuge, the system has grown to more than 500
refuges with more than 150 million acres of land, submerged land and waters,
including nearly 18 million acres in the lower 48 states.

In 1943, the Interior Department’s Fish and Wildlife
Service acquired 8,808 acres on the Virginia end of Assateague Island and established
the Chincoteague National Wildlife Refuge as a winter habitat for the migrating
greater snow goose and other birds. The refuge has since grown to more than 14,000
acres with about 280 species of birds.

The Maryland part of the island was on its way to
being developed in residential lots when a powerful storm in 1962 washed over
the island and destroyed roads. Developers abandoned their plans, and in 1965
President Lyndon Johnson designated the Assateague Island National Seashore on
the rest of the barrier island.

Were it not for the two designations, Assateague
likely would be as heavily developed as Ocean City and Virginia Beach.

Even 50 years ago, it wasn’t easy to set the land
aside. Some local officials favored a commercial beach with concessions and
restaurants, and others complained that only “the magnifying-glass nature lover
and the bird watcher” would come to the national seashore.

Today, people can hunt and fish and drive vehicles
on the sand at certain times. Currently, the Over-Sand Vehicle Zone is
completely closed to 4x4 vehicles, horseback riding and pedestrians to help the
endangered piping plover and other birds nest on the beach.

Wildlife comes first – as it should. That’s why they
call it a wildlife refuge and a haven for wild ponies.